Esophageal Angiolipoma: A Tongue-Like Mucosal Mass

Abstract

A 60-year-old man presented to our hospital for a 6-month history of belching and vomit, occasionally accompanied by a reducible purple “tongue-like” foreign body seen in the oral cavity. Upon presentation, physical examination and laboratory studies were unremarkable. Esophagogastroduodenoscopy revealed a smooth and soft pedunculated mass measuring 10 × 3.5 cm originated about 19–31 cm from the incisors (Figure A). Endoscopic ultrasonography revealed a mucosal mass with homogeneous hyperechoic echogenicity, without malignant features (Figure B). Enhanced computed tomography indicated a unevenly thickened wall of the esophagus and a fat-density lesion occupying two-thirds of the esophageal lumen (Figure C). Endoscopic mucosal resection was performed uneventfully (Supplemental Video 1). Histopathological examination showed mature lipocytes intermixed with hyperplastic capillaries, which was consistent with angiolipoma (Figure D). The patient was discharged 5 days later asymptomatically, and no recurrence was noticed during a 2-month follow-up. Esophageal angiolipoma is an extremely rare benign esophageal tumor with good prognosis. It grows slowly and has a tendency to be pedunculated. The case may remind us that esophageal polypoid mass, characterized as homogeneous hyperechoic echogenicity in endoscopic ultrasonography and a fat-density lesion in the enhanced computed tomography, should raise the suspicion for esophageal angiolipoma. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiI2YmZmOTMxZDU4NzU4YjUzOTZkZGNkZjQ5MjM1MDRkNiIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjQxMzcwMzQ5fQ.BfoandhM5uP3_CgHwUY5ujUeMKUrVOPKsHB9LgAJjhiQ9AGU7RMM4tBkb7UcdrHZhmCqP-8cuKqUcK29AtQXWvqshdAHqXDWb9gQVX2UShHvon6fszvGq8-2ro5P9lOcVbUiLku89YTu9UfNfRLd4BLCkoXV8HvkexUgFjUASFAc8BRXMlsClqCVz-cwP-wT6Ey6IsLV7CrNVi68lU_nWwF-dOpmTWsXhnkAx_AgiXYZ7PBFqrQbTzcRfCjKB5al6T-a0Do-SBUvpZYoWYJCmQiJ8RQ82neqU5_1R6he3sz_awmdBwCqmDuePEVXQz_zlTdkJj8GN1ANg4mg3DgDOw Download .mp4 (48.44 MB) Help with .mp4 files Supplement Video 1